Psychotic Disorders
Table of Contents
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- Mood Disorders with Psychotic Features
- Major Depressive Disorder (MDD) with Psychotic Features
- Bipolar I Disorder, Manic or Mixed with Psychotic Features
- Schizophrenia
- Schizoaffective DisorderY
- Substance-Induced Psychotic Disorder
- Psychotic Disorders Due to a General Medical Condition (GMC)
- Delusional Disorder
Psychotic Disorders
Objectives
- Appreciating the prevalence of various psychotic illnesses
- Describing the key features of various psychotic illnesses
- Understanding how to differentiate between psychotic illnesses
- Selecting psychopharmacologic treatment for various psychotic illnesses
- Applying general principles on how to approach a patient with psychosis
Terminology
Psychosis
- Disorder of thinking and perception where typically patients do not ascribe their symptoms to a mental disorder.
Positive Symptoms
- Delusions, hallucinations, thought disorder.
Negative Symptoms
- A deficit state – what is not there.
Delusion
- False unshakeable belief out of keeping with the patient’s cultural, educational, and social background.
Hallucination
- A sensory perception experienced in the absence of a real stimulus.
Prodrome
- A definable period before the onset of psychotic symptoms during which functioning becomes impaired.
Frequency
- 1 yr prevalence of non-organic psychosis is 4.5/1000 community residents.
- Commonest age of presentation:
- Men < 30
- Women < 35
- People > 60.
- Schizophrenia has a 1 yr prevalence of 3.3/1000 and lifetime morbidity of 7.2/1000.
- Psychotic symptoms have a 10.1% prevalence in non-demented community > 85yrs.
Take Home Points
- Psychotic disorders can be primary or secondary.
- Cornerstone of treatment is antipsychotics if primary psychotic illness.
- If secondary psychotic illness, treat underlying cause and often will also need to use antipsychotics.
- There are approaches as outlined earlier that can make interactions with patients more effective.